Nurse phone lines and internet routing by medical professionals can relieve bottlenecks in the system.

Even where the current routing system works well, it can be improved using advances in technology. The advent of email and other forms of electronic information and communication have changed our expectations of response time. The medical routing system should make use of these advances to build on the existing structure, speed response time and improve outcomes.

Perhaps the best way to think about an effective rapid-response system is ‘Triage on Steroids’…or ‘Super - 911.’

A routing service should be available 24 hours a day, seven days a week, and be performed by a knowledgeable and capable medical professional. This is the gold standard of medical routing. The system should be accessible via phone, Internet, and in person. Most of the traffic should be handled by phone or electronically; for in-person routing, the staffed routing site might be near to—but separate from—an emergency room, or perhaps at a pharmacy.

The first task of a routing service is to serve as a “super-911,” to identify emergencies and reassure if urgent care is not needed.

Second, if it is not an emergency, the intake specialist could determine the complexity of the response needed. Patients requiring a simple, standard response, especially preventive care such as flu shots, could be directed to a preventive care clinic (see Step I). Patients with more complex problems should be directed to their primary care provider or, where the determination can be readily made and the primary care provider is otherwise overburdened, an appropriate specialist. Finally, patients with especially complex problems might be referred to a superdoctor team (see Step III).